The care of young adults with hyperthyroidism constitutes a reasonable portion of clinical endocrine outpatient work. Here, Witczak and colleagues remind us of the risk of cardiac complications from uncontrolled thyroid overactivity. The myocardium, vasculature and autonomic nervous system are all directly affected by thyroid hormones. Tachyarrhythmias and cardiomyopathy, eventually resulting in cardiac decompensation, can result from thyroid hormone excess.

The authors report the cases of three patients, aged 28, 34 and 42, who developed significant cardiac disease having had symptoms suggestive of thyrotoxicosis for weeks to months. None of the patients had prior history of heart problems, yet all presented with cardiomegaly with or without pericardial effusion with or without reduced ejection fraction.

All three were treated supportively and underwent early definitive treatment for their Graves’ disease. Importantly, considerable improvements in cardiac health were observed for each patient, following treatment of the thyroid overactivity.

Read the full article in Endocrinology, Diabetes & Metabolism Case Reports EDM190132